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Meter Swap .� � � Request Number: 15033 Public Works Division Service Request Problem Addreas: 5085 Hughes Ave Requested By: Enid Departme�: WA'IER Addresa: No ad�ess provided Problem/Iss�: INSTALL AMR ME'IER P�oae Number: 612-701•6941 Schednle e: 201'I-OS-03 � , Sched�i�1lme: 09:0(1:00 �t 'C� � ACIION NEEDED: Cres�ted by: Wendy Hia�t Date Created: 2017-04-28 ACTION TAI� : _ � ..�' "__� Status: In Progress ��er H�Beea �, Co�acted Date Completed: Completed by: �� J^ � �� h (V� � ��i �� ,� (� � �VI�G � , City of Fridley Water Department 6431 University Avenue NE Fridley,MN 55432 763-572-3566 ��We hereby authorize the City of Fridley and/or its employees to do what ts necessary to replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all iMerior plumbing. (Per City code 402.06) i also hold the City of Fridley and/its empioyees harmless for any damages that may occur while doing thts operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service Itne. in undentand I am also required to obtain a permit prior to any work,ff necessary. FlNAL METER EADtNG(old meterj O � I � � � O Name• � Address �� Phone Number �FJ '� �� f , Date �r �� Signature _ `-� \ �� Witness Signature OLD METER# �� 1J L ��S OLD READING __ �� I S C'� ` � NEW METER# `�1� r O� I �` NEW READING_� ERT# � � v�Q��V FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to construding or repair of arry water of sewer line connectiog the existing municipal system and aml house or building for which the application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a perm�t fee as provided in Chapter ii of this Code. After such con�ection has been made,the Water and Sewer Department shall be notffied. It shall be unlawful to�ver any connecting tine until an inspection has been made and such connection and the work incident thereto has been approved by the C�ty as a proper and suitable connedion. 402.06 REPAlRS AND MAINTENANCE TO CONNECTION After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a wzter service lead has been extended to the property line for connection,the applicant,ovuner,or occupant or user of wch premises shali be liable for all repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property oarner requests maintenance service or repairs be performed by the Gty,the property owner shall be charged for the costs of the maiMenance and/or repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicant, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding deb�is dearing or root cutting and to maintain#he water service curb stop box for operability and at such height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191) �� ;�� : �� , � �l��, � � ��s�� City of Fridley Water Devartmst�t Address �J V� ��'��`� Name '� �.4�16�d�., Date �`'"1'`�V Old Meter Number � �JU� Old Meter Reading �� Replacement No. � � Replacement Reading � Replacement Make ��-��- - ' Remarks• ;�� '�'YFe�^' Signed !